The Clinical Services Department comprises the Gate Clinic, the Outpatients Department, the Ward, clinical laboratories and diagnostic facilities. High-quality, efficient health care services are offered to Gambians, nationals of other countries in the sub-region and visitors from all over the world.

Gate Clinic
Run by a nursing sister and two enrolled nurses, the Gate Clinic registers an average of 250 new patients every day. The Gate Clinic is an invaluable resource to researchers seeking to recruit patients and control subjects, whilst offering training in triage and primary health management of patients.

Outpatients Department
The Outpatients department includes the general OPD and staff clinic (which services over 2500 workers and their family members). On average, 4 physicians cover the general clinic daily (excluding the TB and GUM clinics) reviewing and following up cases referred from the Gate Clinic; managing new patients and referrals from government hospitals, private hospitals and non-governmental organisation. Four physicians cover the two specialised clinics: the Genito-Urinary Medicine (GUM) clinic (to which HIV cases are referred) and the tuberculosis clinic.

Paediatric and adult medical cases are managed at the Unit; surgical, gynaecological and obstetrics cases are stabilized and subsequently referred mainly to the Royal Victoria Teaching Hospital in Banjul or the private hospital of the patient’s choice.

Audio and visual public health educational materials are provided for patients as they wait to be reviewed by clinicians and nursing staff.

Ward
The busy 42-bed ward is run by two medical officers and a senior clinician, under the supervision of the Director of Clinical Services. Major causes for admission include acute emergencies such as severe anaemia, severe malaria and acute respiratory infections in the paediatric age group. Patients admitted are reviewed daily by the medical officers and are reviewed thrice weekly by the appropriate consultants and the Director of Clinical Services. Important and necessary diagnostic procedures/investigations are also carried out.

On-going clinical research at the Ward includes studies on bacteraemia, malaria and severe anaemia, malnutrition and renal diseases in Gambian children.

Open weekly clinical meetings are conducted, as well as monthly xray and mortality reviews, attended by medical personnel from the Royal Victoria Teaching Hospital.

Diagnostic services
The well-equipped research and routine laboratories staffed by highly skilled personnel provide diagnostic services to in-patients and out-patients. Services on offer include haematology, biochemistry, microbiology, imaging (ultrasonography and X-ray) and diagnostic endoscopy. All routine laboratories belong to UKNEQAS or WHO quality-control schemes.

Training
MRC Gambia’s Clinical Services department provides good training for students from all over the world. Student nurses from nursing schools in The Gambia and further afield also gain practical experience in infectious diseases.

Medical students from Ghana, Nigeria, Sierra Leone and other parts of Africa, Europe and America come to the department for their elective periods.

MSc students from the Liverpool School of Tropical Medicine are regular visitors here.
Diploma in Tropical Medicine & Hygiene (DTM&H) students from the London School of Hygiene and Tropical Medicine spend 2 weeks here immediately after graduation.

Over the years a few training fellows preparing for their Part 2 fellowship examinations of the West African College of Physicians (including paediatrics) have visited the Unit, funded by MRC.

Field Sites
More limited clinical services are offered at the MRC Farafenni, Keneba and Basse field sites, with emergency cases referred to MRC Fajara. These field sites work very closely with the Government services. In Basse and Farafenni MRC clinical services are amalgamated with the Government services, which helps to foster a spirit of true partnership, capacity development and empowerment.